NSTK · 01.2026Independent supplement reference
NutriStack
Edition 1.0Updated July 13, 2026

Clarithromycin

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

A macrolide antibiotic with activity against gram-positive cocci, atypical organisms (Mycoplasma, Chlamydia, Legionella), and Mycobacterium avium complex (MAC). Used for community-acquired pneumonia, acute bacterial sinusitis, pharyngitis, acute exacerbations of chronic bronchitis, skin infections, and as a key component of H. pylori triple therapy. Notable for significant CYP3A4 inhibition, which causes numerous drug interactions.

Evidence tier
Strong
Indexed sources
10 1991–2025
Interactions
0
Depletes
1 nutrient
Read the sources → Compare profiles
Publication status

Exploratory record, not a reviewed medical publication.

See the editorial and medical-review policies for the publication gate.

This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

A macrolide antibiotic with activity against gram-positive cocci, atypical organisms (Mycoplasma, Chlamydia, Legionella), and Mycobacterium avium complex (MAC). NutriStack rates the supporting evidence as strong. Common adult dosing is 250-500 mg every 12 hours; XL: 1000 mg once daily; H. pylori: 500 mg BID for 10-14 days as part of combination therapy (as prescribed by your physician), though a prescriber sets the actual dose. With long-term use it can deplete vitamin k. This profile indexes 10 sources.

What it's good for
  • Treats community-acquired pneumonia8
  • Key component of H. pylori triple/quadruple therapy1,2
  • Treats MAC infections in immunocompromised patients
  • Treats acute bacterial sinusitis
  • Treats acute exacerbations of chronic bronchitis4,9
What to watch for
  • Dysgeusia (metallic taste, very common)
  • Diarrhea
  • Nausea and vomiting
  • Known hypersensitivity to clarithromycin or any macrolide1,2
  • Concomitant use with colchicine in patients with renal/hepatic impairment

The bottom line

Evidence rating strong. Most-documented uses: treats community-acquired pneumonia, key component of h. pylori triple/quadruple therapy, treats mac infections in immunocompromised patients. 10 sources indexed (1991–2025), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Binds to the 50S ribosomal subunit at the 23S rRNA peptidyl transferase center, blocking peptide chain elongation and inhibiting bacterial protein synthesis. Primarily bacteriostatic. Its active metabolite, 14-hydroxyclarithromycin, also has antibacterial activity and acts synergistically with the parent compound against H. influenzae. Clarithromycin is a potent inhibitor of CYP3A4, CYP2C9, and P-glycoprotein, leading to significant drug-drug interactions.

Class
Macrolide Antibiotic
Absorption
Water-soluble; take with food
Dosing

Dosing & protocol.

Common range
250-500 mg every 12 hours; XL: 1000 mg once daily; H. pylori: 500 mg BID for 10-14 days as part of combination therapy (as prescribed by your physician)
Recommended form
Oral tablets (immediate-release or extended-release) or suspension

Bioavailability approximately 50%. Food improves tolerability. Extended-release tablets (Biaxin XL) should be taken with food to optimize absorption. IMPORTANT: Potent CYP3A4 inhibitor, numerous significant drug interactions.5

Depletions

What it depletes.

Nutrients this medication can lower over time, and what to replace.

Vitamin K

Mild

Broad-spectrum antibiotic exposure can suppress gut bacteria that synthesize menaquinones, lowering vitamin K availability in susceptible patients.

Monitor PT/INROnset Usually with prolonged therapy, poor intake, or malabsorption

Full Clarithromycin depletion and interaction guide →

Safety

Full safety detail.

Side effects

  • Dysgeusia (metallic taste, very common)
  • Diarrhea
  • Nausea and vomiting
  • Abdominal pain
  • Headache
  • QT prolongation
  • Hepatotoxicity (rare)

Contraindications

  • Known hypersensitivity to clarithromycin or any macrolide1,2
  • Concomitant use with colchicine in patients with renal/hepatic impairment
  • Concomitant use with pimozide, cisapride, ergotamine, or lovastatin/simvastatin
  • History of QT prolongation or ventricular arrhythmia
  • History of cholestatic jaundice/hepatic dysfunction with prior clarithromycin use
  • Severe hepatic impairment combined with renal impairment
Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

5

Reviews & position papers

1

Reference material

4
FAQ

Common questions.

Quick answers about Clarithromycin, drawn from the data on this page.

What is Clarithromycin?

A macrolide antibiotic with activity against gram-positive cocci, atypical organisms (Mycoplasma, Chlamydia, Legionella), and Mycobacterium avium complex (MAC). Used for community-acquired pneumonia, acute bacterial sinusitis, pharyngitis, acute exacerbations of chronic bronchitis, skin infections, and as a key component of H. pylori triple therapy. Notable for significant CYP3A4 inhibition, which causes numerous drug interactions.

What is Clarithromycin used for?

Commonly cited benefits of Clarithromycin include: Treats community-acquired pneumonia; Key component of H. pylori triple/quadruple therapy; Treats MAC infections in immunocompromised patients; Treats acute bacterial sinusitis; Treats acute exacerbations of chronic bronchitis. NutriStack rates the overall evidence as strong.

What is a typical dose of Clarithromycin?

A typical adult dose of Clarithromycin is 250-500 mg every 12 hours; XL: 1000 mg once daily; H. pylori: 500 mg BID for 10-14 days as part of combination therapy (as prescribed by your physician). The commonly recommended form is Oral tablets (immediate-release or extended-release) or suspension. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Clarithromycin?

Reported side effects include dysgeusia (metallic taste, very common), diarrhea, nausea and vomiting, abdominal pain, headache, qt prolongation. This is educational information; check with a healthcare professional before use.

How strong is the evidence for Clarithromycin?

NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

Clarithromycin in NutriStack.

Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.

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NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.